Moving the Resident from a Bed to a Stretcher or Gurney

Written by Hollie Finders, RN
Hollie Finders is a registered nurse with years of experience working in the health care field. She has degrees in both biochemistry and nursing. After working with patients of all ages, Hollie now specializes in pediatric intensive care nursing. Hollie’s LinkedIn

Procedure

Equipment needed: 2-3 coworkers, bath blanket, stretcher or gurney

  1. Perform hand hygiene.
  2. Explain the procedure to the patient and ask for his or her assistance in following directions.
  3. Lock the bed wheels and raise the bed to a comfortable working height.
  4. Lower the head of the bed until flat. Lower the side rail on the working side.
  5. Cover the patient with a bath blanket and remove the patient’s top sheets.
  6. Loosen the bottom sheet from underneath the patient. Roll the bottom sheet towards the patient.
  7. Align the stretcher next to the patient’s bed. Ensure the side rails are down, the wheels are locked, and that the height of the stretcher matches that of the bed.
  8. Have a coworker or two lower the side rail on the other side of the bed, loosen the bottom sheet, and roll it towards the patient.
  9. Instruct the patient to cross his or her arms across the chest. Ensure the patient is ready for the transfer and inform the patient when it will happen.
  10. With a coworker joining you on your side, reach over the stretcher and grab the roll of sheets. Have the coworkers on the other side of the bed grab the roll of sheets on their side.
  11. On the count of three, have everyone gently lift and slide the patient onto the stretcher. Use proper body mechanics to avoid injury.
  12. Raise the side rails on the stretcher.
  13. Unlock the stretcher’s wheels and transport the patient to the desired destination with the assistance of another coworker. Do not leave the patient alone in the stretcher.

Important Information

Moving a patient from a bed to a stretcher can pose huge safety risks to both the patient and to the health care workers completing the transfer. Always use the appropriate amount of people to complete a transfer, which may vary according to the patient’s weight and/or the facility’s policy. In some cases, a mechanical lift may be needed [1]. Before moving the patient, always ensure that the transfer can occur in one fluid motion. For instance, make certain that there is enough slack on a patient’s oxygen tubing or IV lines to avoid injuring the patient or damaging the equipment.

References

  1. Guidelines for Nursing Homes
More Resources

Applying Restraints

Restraints have very strict guidelines for use due to the number of complications that can result. Use of restraints is associated with increased physical and psychosocial health issues. Restraints are only considered necessary when restraint-free alternatives have failed and the patient or others are at risk of harm without the restraints. It is illegal to use restraints for the staff’s convenience or to punish the patient.

Transferring the Resident from a Bed with a Mechanical Lift

A mechanical lift is used to transfer residents who cannot support their own weight. When used properly, mechanical lifts prevent injuries for both residents and health care workers. It is important that a nurse’s assistant be trained to use the mechanical lift before attempting to operate it. Most facilities require at least two health care workers to assist when using a mechanical lift.

Axillary Temperature with Electronic Thermometer

Compared to other temperature measurement methods, the axillary measurement is considered the least reliable. An axillary temperature measurement typically reads 0.5 to 1 degree Fahrenheit lower than an oral temperature reading [1]. For this reason, it is recommended to use this method only when other methods are contraindicated or when taking an axillary temperature is the safest method for the patient.

Perineal Care of the Male Resident

Perineal care should be performed during a bath, after using the bedpan, and/or after incontinence. Special care should be used when performing perineal care on an uncircumcised male. Failure to retract and wash the area under the foreskin can result in infection. Failure to return the foreskin to its normal position can result in paraphimosis.

Prone Position

Prone position is not used as commonly as other patient positions. This position allows for full extension of the hips and the knees and gives many bony prominences a break from continuous pressure. However, placing patients in prone position does not come without the risks of pressure ulcers.

Measuring the Radial Pulse

The radial artery, located in the wrist, is easy to feel and an efficient location to measure heart rate. Changes to the rhythm or strength of the radial pulse can indicate heart disease, damage to the arm, or body fluid status. It is important to remember to check the radial pulse on both sides as differences between left and right can indicate injury or disease processes.